Total and Regional Changes in Body Composition in Metastatic Hormone-sensitive Prostate Cancer Patients Randomized to Receive Androgen Deprivation + Enzalutamide ± Zoledronic Acid. The BONENZA Study

作者：Martina Buffoni, Alberto Dalla Volta, Francesca Valcamonico, Marco Bergamini, Irene Caramella, Donatella D'Apollo, Andrea Zivi, Giuseppe Procopio, Pierangela Sepe, Gianluca Del Conte, Nunzia Di Meo, Silvia Foti, Stefania Zamboni, Caterina Messina, Eleonora Lucchini, Roberto Maroldi, Marta Laganà, Marco Ravanelli, Manuel Zamparini, Francesca Zacchi, Nazareno Roberto Suardi, Davide Farina, Alfredo Berruti · 发表于：European Urology Oncology · 年份：2025 · DOI：10.1016/j.euo.2025.02.006 · 被引用次数：5 · 研究领域：Nutrition and Health in Aging、Prostate Cancer Treatment and Research、Prostate Cancer Diagnosis and Treatment

BACKGROUND AND OBJECTIVE: The reduction of lean body mass (LBM) and the increase of fat body mass (FBM) caused by androgen deprivation therapy (ADT) administered to prostate cancer patients are well known to lead to an increased risk of sarcopenia. The effects of the addition of androgen receptor pathway inhibitors (ARPIs) to ADT on body composition have not been studied thoroughly. METHODS: BONENZA (NCT03336983) is a prospective phase 2 trial in which metastatic hormone-sensitive prostate cancer patients were randomized to receive ADT plus enzalutamide with (EZ arm) or without (E arm) the addition of zoledronic acid. Total and regional body composition parameters were evaluated by dual-energy x-ray absorptiometry (DXA) scans at baseline and after 18 mo of therapy. KEY FINDINGS AND LIMITATIONS: Eighty-nine patients (46 from the EZ arm and 43 from the E arm) had paired DXA evaluation at both time points. After 18 mo of therapy, FBM increased by +22.8% (p < 0.001), LBM reduced by -6.7% (p < 0.001), and appendicular lean mass index (ALMI) decreased by -9.2% (p < 0.001). The increase in FBM varied considerably according to body districts: from +36.1% in the right arms (p < 0.001) to +3.7% in the head (p < 0.01). Similarly, the decrease in LBM ranged from -9.4% (p < 0.001) in the right arm to -6.4% (p < 0.001) in the trunk. None of the patients met the criteria for sarcopenic obesity; however, after 18 mo of treatment, 11.76% of patients had FBM >40.8%, 3.5% of patients had an ALM...